Case Study

FIELD CASE MANAGEMENT

Start Date
January 2009
End Date
Ongoing
Total Savings
$19,038,613

For a period of six years, MC Innovations provided the Commonwealth with an intense telephonic nurse case management program (TCM) to manage the delivery of medical care to injured workers. After six years, a decision was made that TCM was not generating optimal results. In summary, a great deal of administrative work was being completed by a dedicated staff of telephonic nurse case managers for a fixed fee. The results were not commensurate with the cost of the TCM program.

Featured Services
Telephonic Nurse Case Management
Field Case Management
Days Saved per Claim
0 %
% Return on Program Cost
0 %
Additional Cost of Program
0 %

THE SITUATION

For a period of six years, MC Innovations provided the Commonwealth with an intense telephonic nurse case management program (TCM) to manage the delivery of medical care to injured workers. After six years, a decision was made that TCM was not generating optimal results. In summary, a great deal of administrative work was being completed by a dedicated staff of telephonic nurse case managers for a fixed fee. The results were not commensurate with the cost of the TCM program. Assigning field case management after day one of lost time yielded superior results.


THE SOLUTION

MC Innovations proposed that the TCM staff be replaced with a dedicated staff of field case managers (FCM). All lost time claims exceeding 30 days out of work were assigned to FCM with a focus of promoting return to work. Based on preliminary results, MC Innovations’ next step was to reduce referral time to FCM from 30 days after the claim was reported to the day the claim was reported.


THE RESULT

The shift from TCM to FCM 30 days after receipt of the lost time claim resulted in an average decrease of 6.0 lost time days the injured worker experienced. The elimination of the 30-day waiting period resulted in an additional decrease in lost time days of 9.6 days. By shifting from TCM to a no lag FCM service, an average of 15.6 days savings were gained. Collectively the reduction in indemnity cost was $2.1 million. As TCM was replaced for the same cost for FCM, there were no additional costs with this transition. There were no increases in administrative costs and the program continues today with periodic refinements and improved results.

Contact MC Innovations for more details on how we produced these winning results.

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